The purpose of this paper is to investigate the difference in concentration of 0.53% betamethasone in aqueour humor after betamethasone subconjunctival injection on upper and lower fornix after cataract extraction. A total of 8 rabbits were used. Cataract extractions were performed with the cryoprobe. After 6 hours, 0.53% betamethasone was subconjunctivally in upper fornix of the left eye and injected in lower fornix of the right eye. The control group of 3 rabbits underwent with the same procedures but the without lens delivery. the concentration of 0.53% betamethasone in aqueous humor was measured with HPLC(High Performance Liquid Chromatograph) after fine needle aspiration of aqueous humor. The results obtained were as follows. 1. In 5 eyes of the control group in 3 rabbits, 0.53%betamethasone was injected subconjunctivally on the lower fornix. The mean concentration of 0.53% betamethasone in aqueous humor was 0.544 +/- 0.0818 microgram/ml. 2. After 0.53% betamethasone subconjunctival injection on upper fornix after lens extraction, the mean concentration of 0.53% betamethasone in aqueous humor was 0.318 +/- 0.0117 microgram/ml. 3. After 0.53% betamethasone subconjunctival injection on lower fornix agter lens extraction, the mean concentration of 0.53%betamethasone in aqueous humor was 0.702 +/- 0.0332 microgram/ml. 4. The mean concentration of the betamethasone in aqueous humor after 0.53% betamethasone subconjunctival injection on lower fornix after lens extraction was significantly higher than on upper fornix(p<0.05).
Aqueous Humor* ; Betamethasone* ; Biopsy, Fine-Needle ; Cataract Extraction ; Rabbits

The various method have been used in reconstruction of the anophthalmic socket. Dermis-fat graft as an orbital implant is a relatively new approach. Dermis-fat graft restores the volume lost by enucleation, gives additional conjunctival lining and is permanent, with a minimal chance of absorption. Dermis-fat graft was used in reconstruction of an ophthalmic socket in our hospital. We found it successful procedure in case of primary enucleation, because it is permanent and it preserves the conjunctiva.
Absorption ; Conjunctiva ; Orbital Implants ; Transplants*

Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. The introdection of intravitreal injection of antibiotics has been a major advancement because it has resulted in a marked improvement in visual outcome. The intravitreal injection of steroids may be potentially useful in the treatment of endophthalmitis and other ocular inflammatory diseases. Forty eyes of pigmented rabbits were used, and divided into two groups. Group I was eyes without vitrectomy. In the right eye, 100 microliter of 1mgvancomycin, 400 microliter amikacin and 400 microliter dexamethasone injected was done. Group II was eyes with vitrectomy and lensectomy. At 2 weeks after lens and vitreous removal, rabbit eyes received an injection of a combination of 1mg vancomycin, 400 microliter amikacin and 400 microliter dexamethasone in right eye and BSS in left eye. The effect of combination injection was examined by light and transmission, scanning electron microscope at 3 days, 1 week, 2 weeks and 6 weeks following injection. The injection of combination without vitrectomy produced no toxicity. After injections of either combination or BSS after vitrectomy, macrophages were observed on the surface of retinal pigment epithelium and disorganized outer segments. This finding seems to be produced by vitrectomy procedure rather than drug toxicity. These results supports the hypothesis that the injection of these combinations is not toxic to aphakic/vitrectomized eyes.
Amikacin ; Anti-Bacterial Agents ; Decision Making ; Dexamethasone* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Emergencies ; Endophthalmitis ; Intravitreal Injections ; Macrophages ; Rabbits ; Retinal Pigment Epithelium ; Steroids ; Vancomycin ; Vitrectomy*

To study the isolation and purification and proliferation of the cell in cell culture system, and to develop an improved culture method by a modified cell isolation technique and modified culture medium. The RPE cells were cultured in 3 different mediums: type I(MEM medium with 20% FCS) type II(F-10 medium with 20% FCS) and type III(DMEM medium with 10% FCS, EGF, hydrocortisone, insulin, ethanolamine, phosphoethanolamine, chorea toxin, triiodotyronine, adenine, transferrin and BPE). We compared population doubling(P.D.), population doubling time(P.D.T), morphologic changes and phagocytic activity during a 7week period. Rapid proliferation and high purity of retinal pigment epithelial cells(RPE cells) showed in type III culture medium. Type III culture medium presented the best results in P.D., P.D.T. and cell purification. In type III culture medium, single RPE cells produced about 6 X 10(7) RPE cells in the 7week period and morphology and phagocytic activity were well maintained, when UV-B irradiation at RPE was used to produce melanin, it had no effect, but the RPE cell was inhibited by UV-B irradiation. This improved culture method for RPE cells will provide a good in-vitro model for the studies of biochemistry, cellular function of the RPE cell, as well as its clinical application in eye disease.
Adenine ; Biochemistry ; Cell Culture Techniques ; Cell Separation ; Chorea ; Epidermal Growth Factor ; Epithelial Cells* ; Ethanolamine ; Eye Diseases ; Hydrocortisone ; Insulin ; Melanins ; Retinaldehyde* ; Transferrin

OBJECTIVE: We report an evaluation of incidence of the traumatic disc herniation and an effect of early closed reduction without prior magnetic resonance(MR) imaging in cervical spine fracture-dislocation injury. METHODS: The medical records and radiologic images of twenty consecutive traumatic cervical spine injury from the C2-3 to C7-T1 were reviewed. The disc injury on MR images was divided into two category: a herniation defined as deforming the thecal sac or nerve root and a disruption defined as a disc with high T2-weighted signal characteristics. Closed reduction was attempted in all patients and neurologic status was measured on admission and following reduction. MR image was obtainted within three days after early closed reduction. RESULTS: Early closed reduction by Gardner-Wells skeletal traction and serial plain radiography was achieved in 90% of patients and there was no associated neurological deterioration after reduction. The incidence of disc injury at the level of the fracture subluxation on the postreduction MR images was 60%(herniation-30%, disruption-30%), but the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association(ASIA) motor score and the Frankel scale following early closed reduction. The average ASIA motor score prior reduction was 48.4 compared with 62.5 following reduction. CONCLUSION: Although disc herniation and disruption can occur following traumatic cervical fracture-dislocation, the actual incidence of neurological deterioration following early closed reduction is rare. Therefore, immediate closed reduction using traction in patients with any neurological deficit can be safe and effective before MR imaging.
Asia ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Medical Records ; Radiography ; Spinal Injuries ; Spine ; Traction

OBJECTIVE: 6R-Tetrahydrobiopterin(BH4) is a cofactor for the aromatic amino acid hydroxylases which is essential for the biosynthesis of catecholamines and serotonin. It also acts as a cofactor for nitric oxide synthase, and stimulates the release of some neurotransmitters such as dopamine, serotonin, acetylcholine and glutamate. Recently, it has been reported that BH4 could induce cellular proliferation and enhance neuronal survival. This study was performed to investigate the antioxidative effect of BH4 on the various oxidative insults in mouse cerebral cortical cell cultures. METHODS: Iron ion(FeCl2), zinc ion(ZnCl2), sodium nitroprusside(SNP) and buthionine sulfoximine(BSO, a glutathione depletor) were used as oxidants. Cell death was assessed by measurement of lactate dehydrogenase efflux to bathing media at the end of exposure. RESULT: All 4 oxidants induced neuronal cell death associated with cell body swelling, which was markedly inhibited by trolox(100nM), a vitamin E analog. BH4(10-100nM) markedly inhibited the neuronal cell death induced by all 4 oxidants(20nM Cu2+, 20nM Zn2+, 1nM SNP or 1mM BSO). However, BH4 failed to inhibit the neuronal cell death induced by 24hr exposure to 20nM NMDA. CONCLUSION: These results suggest that BH4 has antioxidative action independently of any actions of enzyme cofactor.
Acetylcholine ; Amino Acids, Aromatic ; Animals ; Baths ; Catecholamines ; Cell Culture Techniques ; Cell Death ; Cell Proliferation ; Dopamine ; Glutamic Acid ; Glutathione ; Iron ; L-Lactate Dehydrogenase ; Mice* ; Mixed Function Oxygenases ; N-Methylaspartate ; Neurons* ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Oxidants ; Serotonin ; Sodium ; Vitamin E ; Vitamins ; Zinc

Kissing aneurysms are very rare with only a few cases having been previously reported in the literature. We report a case of aneurysms arising from bilateral distal anterior cerebral arteries. A 56-year-old man was admitted to our hospital with subarachnoid hemorrhage. CT angiogrms and cerebral angiograms showed mirror image aneurysms touching each other were located at bilateral distal anterior cerebral arteries. During operation we confirmed the aneurysms were in contact.
Aneurysm* ; Anterior Cerebral Artery* ; Humans ; Middle Aged ; Subarachnoid Hemorrhage

OBJECTIVE: Civilian gunshot injuries to the brain are relatively rare and study of these injuries has been neglected in South Korea. We present our experience with penetrating gunshot injuries to the brain and review the outcome of surgical management, as well as other clinical predictors influencing the prognosis. METHODS: We present a retrospective analysis of 13 patients with penetrating gunshot injuries to the brain who were treated at our hospital over a period of 22 years. RESULTS: The Glasgow Coma Scale(GCS) score on admission was recorded to be : 3-5 in 1 patient, 6-8 in 3 patients, 9-12 in 2 patients and 13-15 in 7 patients. There were 11 patients who underwent surgical treatment, and the surgical mortality rate was 0%. The admission GCS score was the most valuable prognostic factor. The best results were found to be in patients admitted with an initial GCS higher than 13. There were no favorable outcomes in patients admitted with a GCS of 8 or lower. There was a correlation between the presence of a transventricular or bihemispheric trajectory and poor outcome. The patients admitted with unilobar wounds resulted in better outcome than those with bilobar or multilobar wounds. Retained deep intracranial bone or metal fragments were the most common postoperative complication. However, retained fragments did not increase the risk of infection or seizure. CONCLUSION: Our results suggest that a less aggressive approach, consisting of minimal local debridement and removal of the bone and metal fragments that are easily accessible, can be successfully used in civilian gunshot wounds to the brain.
Brain Injuries ; Brain* ; Coma ; Debridement ; Glasgow Coma Scale ; Humans ; Korea ; Mortality ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Seizures ; Wounds and Injuries ; Wounds, Gunshot

OBJECTIVE: Burr hole drainage has been widely used to treat chronic subdural hematoma (CSDH). However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery. The authors attempted to elucidate the risk factors associated with the recurrence of CSDH in one burr hole drainage technique. METHODS: A total of 255 consecutive cases who underwent one burr hole drainage for CSDH were included in this study. Twenty-four patients (9.4%) underwent a repeated operation because of the recurrence of CSDH. We analyzed retrospectively the demographic, clinical and radiologic factors associated with the recurrence of CSDH. RESULTS: In this study, two risk factors were found to be independently associated with the recurrence of CSDH. The incidence of CSDH recurrence in the high- and mixed-density groups was significantly higher than those in the low- and iso-density groups (p<0.001). Bleeding tendency such as in leukemia, liver disease and chronic renal failure was also significantly associated with recurrence of CSDH (p=0.037). CONCLUSION: These results suggest that high- and mixed-density shown on computed tomographic scan was closely relates with a high incidence of recurrence. Therefore, the operation could be delayed in those cases unless severe symptoms or signs are present. Reoperation using the previous burr hole site is a preferred modality to treat the recurrent CSDH.
Drainage ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic ; Leukemia ; Liver Diseases ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors

OBJECTIVE: Water-tight closure of the dura in extracranial-intracranial (EC-IC) bypass is impossible because the superficial temporal artery (STA) must run through the dural defect. Consequently, subdural hygroma and subcutaneous cerebrospinal fluid (CSF) collection frequently occur postoperatively. To reduce these complications, we prospectively performed suturing of the arachnoid membrane after STA-middle cerebral artery (STA-MCA) and evaluated the clinical usefulness. MATERIALS AND METHODS: Between Mar. 2005 and Oct. 2010, extracranial-intracranial arterial bypass (EIAB) with/without encephalo-myo-synangiosis was performed in 88 cases (male : female = 53 : 35). As a control group, 51 patients (57 sides) underwent conventional bypass surgery without closure of the arachnoid membrane. Postoperative computed tomography (CT) scan was performed twice in three days and seven days later, respectively, for evaluation of the presence of subdural fluid collection and other mass lesions. RESULTS: The surgical result was excellent, with no newly developing ischemic event until recent follow-up. The additional time needed for arachnoid suture was five to ten minutes, when three to eight sutures were required. Post-operative subdural fluid collection was not seen on follow-up computed tomography scans in all patients. CONCLUSION: Arachnoid suturing is simple, safe, and effective for prevention of subdural fluid collection in EC-IC bypass surgery, especially the vulnerable ischemic hemisphere.
Arachnoid* ; Cerebral Arteries ; Cerebral Revascularization ; Cerebrospinal Fluid ; Female ; Follow-Up Studies ; Humans ; Membranes* ; Prospective Studies ; Subdural Effusion ; Sutures ; Temporal Arteries